Responding to Decreases in Scores on Measurement-Informed Care Surveys and Clinical Improvement

This article outlines strategies and tips therapists can use with clients to address decreases in symptom severity identified by measurement-informed care (MIC) surveys and noted clinical progress.

Strategies for responding to decreases in scores on surveys

Here are some strategies and tips for addressing marked clinical improvement on MIC surveys. 

Highlight clinical progress

A key strength of measurement-informed care is that the data is self-reported by the client. It focuses on their experience, not your assessment. Tracking how scores (based on their responses) decrease over time becomes a powerful tool. It offers objective evidence of progress, especially for clients who struggle to see their own improvement.

Consider holding space in session to pull up past scores (overall or by item level) to discuss the client's journey. Explore changes since their baseline: What has improved? What efforts or changes have contributed to this progress? This helps clients connect the dots between the process of self-monitoring symptoms (via routine completion of self-report measures) and achieving their treatment goals.

Review, reflect, and celebrate often

Treatment momentum matters. Seeing positive changes fuels motivation and keeps clients engaged in treatment. Regularly reviewing self-reported measures is an excellent way to build and maintain this momentum, allowing both you and the client to celebrate even small improvements. Every step counts!

For example, imagine a client struggling with anxiety. Six weeks ago, they reported having trouble relaxing "nearly every day" (prompt #4 on the GAD-7). Today, they report  "several days." Celebrate this decrease in frequency! Acknowledge their progress, even if there's more work to be done.

Loop back to the treatment plan

As progress shows (through improved scores and achieved goals), it's time to revisit the treatment plan. There should be a collaborative discussion focused on whether initial treatment goals and objectives have been met and if new ones are needed. 

Many therapists target one or two specific symptoms at a time. For instance, with a client scoring high for depressive symptoms on the PHQ-9, we might initially focus on feelings of worthlessness and failure, as decided collaboratively with the client, building objectives and interventions around that. Once improvement occurs, the treatment plan can be updated to reflect new goals and objectives addressing other symptoms of depression that may be present, such as lethargy and poor sleep.

Key takeaways

Reviewing MIC survey scores can serve as a celebration opportunity! It's a chance for you and your client to acknowledge progress, big or small. This reflection helps clients see changes they might miss, keeps them motivated, and builds hope for the future.

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